Mechanics of Breathing

The four primary functions of the respiratory system are:

1 Exchange of gases between the atmosphere and the blood. The body brings in O2 for
distribution to the tissues and eliminates CO2 waste produced by metabolism.

2 Homeostatic regulation of body pH. The lungs can alter body pH by selectively retaining
or excreting CO2.

3 Protection from inhaled pathogens and irritating substances. Like all other epithelia that
contact the external environment, the respiratory epithelium is well supplied with defense
mechanisms to trap and destroy potentially harmful substances before they can enter the
body.

4 Vocalization. Air moving across the vocal cords creates vibrations used for speech,
singing, and other forms of communication.

External respiration
1 The exchange of air between the atmosphere and the lungs. This process is known as
ventilation, or breathing. Inspiration (inhalation) is the movement of air into the lungs.
Expiration (exhalation) is the movement of air out of the lungs. The mechanisms by which
ventilation takes place are collectively called the mechanics of breathing.

2 The exchange of O2 and CO2 between the lungs and the blood.

3 The transport of O2 and CO2 by the blood.

4 The exchange of gases between blood and the cells.

respiratory system

1 The conducting system of passages, or airways, that lead from the external environment
to the exchange surface of the lungs.

2 The alveoli (singular alveolus) {alveus, a concave vessel}, a series of interconnected sacs
and their associated pulmonary capillaries. These structures form the exchange surface,
where oxygen moves from inhaled air to the blood, and carbon dioxide moves from the
blood to air that is about to be exhaled.

3 The bones and muscles of the thorax (chest cavity) and abdomen that assist in ventilation.

 upper respiratory tract consists of the mouth, nasal cavity, pharynx, and larynx
 lower respiratory tract consists of the trachea, two primary bronchi {bronchos,
windpipe; singular— bronchus}, their branches, and the lungs
The Airways Warm, Humidify, and Filter Inspired Air
1 Warming air to body temperature (37 C), so that core body temperature does not change
and alveoli are not damaged by cold air;

2 Adding water vapor until the air reaches 100% humidity, so that the moist exchange
epithelium does not dry out; and

3 Filtering out foreign material, so that viruses, bacteria, and inorganic particles do not
reach the alveoli.

Alveoli Are the Site of Gas Exchange

 type II alveolar cells synthesize and secrete a chemical known as surfactant.
 aid lungs as they expand during breathing
 also help minimize the amount of fluid present in the alveoli by transporting solutes,
followed by water, out of the alveolar air space
 larger type I alveolar cells occupy about 95% of the alveolar surface area and are
very thin so that gases can diffuse rapidly through them

Pulmonary Circulation Is High-Flow, Low-Pressure

 At any given moment, the pulmonary circulation contains about 0.5 liter of blood,
or 10% of total blood volume. About 75 mL of this amount is found in the
capillaries,
 The rate of blood flow through the lungs is much higher than the rate in other
tissues [p. 466] because the lungs receive the entire cardiac output of the right
ventricle: 5 L>min
 resistance of the pulmonary circulation is low

Gas Laws
 Because atmospheric pressure varies with altitude
 The pressure of an individual gas in a mixture is known as the partial pressure of the
gas (Pgas)
Air Is a Mixture of Gases
 78% of the total pressure is due to N2, 21% to O2
 The pressure exerted by an individual gas is determined only by its relative
abundance in the mixture and is independent of the molecular size or mass of the
gas

Boyle’s Law Describes Pressure-Volume Relationships

 chest volume increases, alveolar pressure falls, and air flows into the respiratory
system
 When the chest volume decreases, alveolar pressure increases, and air flows out into
the atmosphere

Ventilation
 A single respiratory cycle consists of an inspiration followed by an expiration

Lung Volumes Change During Ventilation

  The volume of air that moves during a single inspiration or expiration is known as
the tidal volume (VT)
 The additional volume you inspire above the tidal volume represents your
inspiratory reserve volume (IRV).
 The amount of air forcefully exhaled after the end of a normal expiration is the
expiratory reserve volume (ERV)
 The volume of air in the respiratory system after maximal exhalation—about 1200
mL—is called the residual volume (RV). Most of this residual volume exists
because the lungs are held stretched against the ribs by the pleural fluid

Lung capacities
 vital capacity (VC) is the sum of the inspiratory reserve volume, expiratory reserve
volume, and tidal volume. Vital capacity represents the maximum amount of air that
can be voluntarily moved into or out of the respiratory system with one breath.
 Vital capacity plus the residual volume yields the total lung capacity (TLC)
 inspiratory capacity (tidal volume + inspiratory reserve volume)
 functional residual capacity (expiratory reserve volume + residual volume).

Intrapleural Pressure Changes During Ventilation

 intrapleural pressure in the fluid between the pleural membranes is normally
subatmospheric
  elastic lungs are forced to stretch to conform to the larger volume of the thoracic
cavity. At the same time, however, elastic recoil of the lungs creates an inwardly
directed force that tries to pull the lungs away from the chest wall
 The combination of the outward pull of the thoracic cage and inward recoil of the
elastic lungs creates a subatmospheric intrapleural pressure of about -3 mm Hg.
 At the beginning of inspiration, intrapleural pressure is about -3 mm Hg
 By the end of a quiet inspiration, when the lungs are fully expanded, intrapleural
pressure falls to around -6 mm Hg (Fig. 17.9, point B2). During exercise or other
powerful inspirations, intrapleural pressure may reach -8 mm Hg or lower.
 Notice that intrapleural pressure never equilibrates with atmospheric pressure
because the pleural cavity is a closed compartment.
 The two factors that have the greatest influence on the amount of work needed for
breathing are the stretchability of the lungs and the resistance of the airways to air
flow.

Lung Compliance and Elastance May Change in Disease States

 the ability of the lung to stretch is called compliance.
 Compliance refers to the amount of force that must be exerted in a body to deform
it. In the lung, we can express compliance as the change of volume (V) that results
from a given force or pressure (P) exerted on the lung: V>P
 Compliance is the reciprocal of elastance (elastic recoil), the ability to resist being
deformed. Elastance also refers to the ability of a body to return to its original shape
when a deforming force is removed
 Pathological conditions in which compliance is reduced are called restrictive lung
diseases.

Airway Diameter Determines Airway Resistance

 Bronchoconstriction increases resistance to air flow and decreases the amount of
fresh air that reaches the alveoli.
 Carbon dioxide in the airways is the primary paracrine that affects bronchiolar
diameter. Increased CO2 in expired air relaxes bronchiolar smooth muscle and
causes bronchodilation
 Histamine is a paracrine that acts as a powerful bronchoconstrictor.
 The primary neural control of bronchioles comes from parasympathetic neurons that
cause bronchoconstriction, a reflex designed to protect the lower respiratory tract
from inhaled irritants.
 , smooth muscle in the bronchioles is well supplied with b2-receptors that respond
to epinephrine. Stimulation of b2-receptors relaxes airway smooth muscle and
results in bronchodilation. This reflex is used therapeutically in the treatment of
asthma and various allergic reactions characterized by histamine release and
bronchoconstriction

Rate and Depth of Breathing Determine the Efficiency of Breathing

 total pulmonary ventilation, the volume of air moved into and out of the lungs each
minute
 Total pulmonary ventilation = ventilation rate x tidal volume
 Some air that enters the respiratory system does not reach the alveoli because part of
every breath remains in the conducting airways, such as the trachea and bronchi
 he conducting airways do not exchange gases with the blood, they are known as the
anatomic dead space. Anatomic dead space averages about 150 mL.
1 At the end of an inspiration, lung volume is maximal, and fresh air from the atmosphere
fills the dead space.

2 The tidal volume of 500 mL is exhaled. However, the first portion of this 500 mL to exit
the airways is the 150 mL of fresh air that had been in the dead space, followed by 350 mL
of “stale” air from the alveoli. Even though 500 mL of air exited the alveoli, only 350 mL
of that volume left the body. The remaining 150 mL of “stale” alveolar air stays in the dead
space.

3 At the end of expiration, lung volume is at its minimum, and stale air from the most
recent expiration fills the anatomic dead space.

4 With the next inspiration, 500 mL of fresh air enters the airways. The first air to enter the
alveoli is the 150 mL of stale air that was in the anatomic dead space. The remaining 350
mL of air to go into the alveoli is fresh air. The last 150 mL of inspired fresh air again
remains in the dead space and never reaches the alveoli.

 more accurate indicator of ventilation efficiency is alveolar ventilation, the amount

of fresh air that reaches the alveoli each minute

Gas Composition in the Alveoli Varies Little During Normal Breathing

 hyperventilation, alveolar PO2 increases, and alveolar PCO2 falls
 hypoventilation, when less fresh air enters the alveoli, alveolar PO2 decreases and
alveolar PCO2 increases.
 (1) the amount of oxygen that enters the alveoli with each breath is roughly equal to
the amount of oxygen that enters the blood, and (2) the amount of fresh air that
enters the lungs with each breath is only a little more than 10% of the total lung
volume at the end of inspiration.

Ventilation and Alveolar Blood Flow Are Matched

 blood flow (perfusion) past the alveoli must be high enough to pick up the available
oxygen
 Capillaries in the lungs are unusual because they are collapsible. If the pressure of
blood flowing through the capillaries falls below a certain point, the capillaries
close off, diverting blood to pulmonary capillary beds in which blood pressure is
higher
 In a person at rest, some capillary beds in the apex (top) of the lung are closed off
because of low hydrostatic pressure
 An increase in the PCO2 of expired air causes bronchioles to dilate. A decrease in
the PCO2 of expired air causes bronchioles to constrict
 If ventilation of alveoli in one area of the lung is diminished, as shown in Figure
17.14b, the PO2 in that area decreases, and the arterioles respond by constricting
Auscultation and Spirometry Assess Pulmonary Function
 Obstructive lung diseases include asthma, obstructive sleep apnea, emphysema, and
chronic bronchitis.
 Asthma is an inflammatory condition, often associated with allergies, that is
characterized by bronchoconstriction and airway edema
 Leukotrienes are lipid-like bronchoconstrictors that are released during the
inflammatory response. Asthma is treated with inhaled and oral medications that
include b2-adrenergic agonists, anti-inflammatory drugs, and leukotriene antagonist